Which medications in the drug class Serotonin-Dopamine Activity Modulators are used in the treatment of Schizophrenia?

Updated: Mar 16, 2018
  • Author: Frances R Frankenburg, MD; Chief Editor: Glen L Xiong, MD  more...
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Serotonin-Dopamine Activity Modulators

Serotonin-dopamine activity modulators (SDAMs) act as a partial agonist at 5-HT1A and dopamine D2 receptors at similar potency, and as an antagonist at 5-HT2A and noradrenaline alpha1B/2C receptors.

Brexpiprazole (Rexulti)

Serotonin-dopamine activity modulator (SDAM) indicated for schizophrenia. Dosage modifications are necessary with renal or hepatic impairment. Dosage modifications are also needed for individuals who are poor metabolizers of CYP2D6, or if coadministered drugs alter metabolism by CYP2D6 or CYP3A4.

Aripiprazole (Abilify, Abilify Maintena, Aristada)

Aripiprazole shows high affinity for D2, D3, 5-HT1A, and 5HT2A receptors and moderate affinity for D4, 5HT2C, 5-HT7, alpha1 adrenergic, and H2 receptors and possesses moderate affinity for the serotonin reuptake transporter. It is thought to be a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and an antagonist at serotonin 5-HT2A receptors, alpha1, and histamine H1 receptors. It is available in tablets, orally disintegrating tablets, and short- and long-term (once-monthly, q6wk) IM injections. The most common adverse effects include headache, nausea, vomiting, insomnia, tremor, and constipation.

Oral aripiprazole is indicated for acute and maintenance treatment of schizophrenia. It is also used for acute and maintenance treatment of bipolar I disorder, adjunctive therapy for major depressive disorder, and treatment of irritability associated with autistic disorder. It is also approved by the FDA to treat schizophrenia in adolescents.

The IM injections are indicated for adults and may be used once monthly (Abilify Maintena, Aristada), every 6 weeks (Aristada 882 mg), or every 2 months (Aristada 1064 mg).

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